Inter-County Ambulance Services Limited

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We looked for evidence that people were always treated with kindness, empathy and compassion. We checked that people’s privacy and dignity was respected, that they understood that they and their experience of how they were treated and supported mattered. We also looked for evidence that every effort was made to take people’s wishes into account and respect their choices, to achieve the best possible outcomes for them.

At our last assessment we did not rate this key question. At this assessment this key question has been rated as good. This meant people were supported and treated with dignity and respect.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

We scored the service as 3. The evidence showed a good standard. The service always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

The service provided care and support that met people's needs. People who were particularly anxious, who were very young or who had cognitive impairment were able to have somebody familiar travel with them. We received positive feedback from people who had used the service for their spouse or relatives. One person told us, “Every member of the team is amazing. Their care, compassion and professionalism are second to none, and they always treat patients with the kindness, dignity and respect they deserve.” Another person said “They were so special. I really wanted to give feedback. It was a difficult time for me and they made all the difference.”

Following the inspection, we also received copies of complimentary emails. One stated, “They managed the situation with reassurance, dignity and composure, which made a significant difference. Their conduct reflects a very high standard of care.”

We scored the service as 4. The evidence showed an exceptional standard. The service treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences.

All ambulance vehicles were equipped with mobile phones that provided access to a translation service. Vehicles also carried whiteboards, which staff used to communicate with people who were hard of hearing or who were unable to communicate verbally. The whiteboards provided a flexible means of communication that could be adapted to meet individual needs.

The service treated people as individuals and, where possible, accommodated their preferences and specific requests. For example, the service undertook a paediatric transfer for a young person who was experiencing high levels of anxiety. The young person's father travelled in the ambulance and mentioned that they were a fan of a popular singer. As all ambulances were equipped with speakers in the rear compartment, the crew played their favourite songs during the journey to help them feel more relaxed and comfortable.

We received information about a person who could become anxious and verbally challenging during transfers. The service knew about the person's specific needs when the transfer was booked and allocated additional time for the journey. This gave staff enough time to support the person appropriately.

Staff adapted transfer arrangements to meet people’s physical and mobility needs. This included adjusting travelling positions. For example, we were informed about a person who would only travel if their stretcher was moved away from the wall. The service moved the stretcher tracks in the vehicle to enable them to travel in the position they had requested.

We were also told about a person who wanted to spend time with their partner who was receiving end-of-life care. The service planned the transfer to meet the person's needs and did not allocate the crew another journey. This allowed the person to spend meaningful time with their partner without feeling rushed.

We scored the service as 3. The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

The service supported patients to have choice and control and make decisions regarding their transport. We were told that people were encouraged to be as independent as possible when moving to and from vehicles and during journeys. The service used equipment such as wheelchairs, ramps and transfer boards to help people maintain their independence and travel safely.

We scored the service as 3. The evidence showed a good standard. The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

The service prioritised patient’s needs, views, wishes and comfort. Staff travelled with people so they could monitor their wellbeing and provide support when needed. They intervened when they saw people were uncomfortable, uncovered or distressed. Staff supported people to use familiar equipment, such as walking sticks, and encouraged them to bring personal items they needed, such as spectacles.

Staff had access to specialist equipment to meet people's individual needs. For example, vehicles carried ambulance trolley stretchers that accommodated bariatric patients. The service also carried specialist paediatric equipment, including a neonatal transport pod for infants and a restraint system for children.

Staff provided people and those close to them with practical help, emotional support and advice when needed.

We scored the service as 3. The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

The service recognised and aimed to meet the wellbeing needs of staff. The service had several long-serving members of staff, which contributed to workforce stability and continuity of care. Staff had access to a crew base room where they could take breaks and wait for bookings. Staff told us they were able to provide feedback and raise concerns, and records confirmed that staff views were actively sought and acted upon. For example, staff could submit suggestions anonymously through a suggestion box. These suggestions were discussed during staff meetings and, where appropriate, implemented. Recent initiatives introduced following staff feedback included laminated airport signs, so people arriving at the airport could easily identify the service crew members, and the installation of a well-known location assistance application on vehicle mobile phones.